The emergency room is my domain. As a paramedic and a PA, I have spent much of my life in and out of emergency rooms—maybe more time in ERs than at home over 40 years in this business. Yet, let me say I am not a fan of ERs for many reasons, mainly due to the providers who seem to staff them. Beyond the nurses’ and the providers’ jabs of “it’s just a virus,” which translates to “don’t waste our time next time!” to the doctors’ complaints that a certain patient came in, prompting me to always want to ask them to make their own list of only those patients they prefer to see. It reminds me of when I worked at the VA after the first Gulf War had started and the soldiers started to come home with PTSD—even if they only “heard” explosions but were never injured. It finally prompted me to ask them, “What did you expect would happen?” They all enlisted, after the war even. Still, like ER docs and ER personnel, “what did you expect?”
I hear this same argument from ER workers and paramedics: “Well, you don’t understand—people just come in for nothing or for things their doctor takes care of,” or “They just use it for primary care.” Better yet, “They just send the bad people to us, and we end up fighting with them,” and so on. One thing I have learned in my 40 years now is that being rude never changes the patient. They come back every time. The homeless guy gets sent back to the ER every time the police tell the patient at 3 am that they “can go to jail, or they can go with the ambulance. Your choice.”
Why not be loving and caring? Why not gently educate the new, maybe socially naïve, mom who is frightened that her most precious cargo comes in with a strange rash, wheezing, and this strange barking cough, and tell her, “Mom, this is not uncommon for babies. They will often get sick to build natural immunity down the road, and you’re a good mom for caring because we see many who don’t care enough about their children.” Instead, they get the silent middle finger jab, “It’s just a virus,” and the implication that “we’re too good for that stuff.”
One would believe that fellow providers might show some extra courtesy, or that experienced ER workers may be able to assess a situation for what it really is. But they don’t, and they too often can’t.
The darkest experience that found its way into my life involved a regional trauma center in Flagstaff, Arizona. I lived in Prescott but happened to be working in Flagstaff during one of the times I was teaching full-time. I received a call from my wife telling me that our oldest son of seven children, Bryton, was in a coma and had been flown out to the Flagstaff ER from Prescott. Apparently, after a day of drinking with his church buddies—ironically, one of his drinking buddies, to this day no one will say—he was beaten into oblivion while he was too drunk to fight back.
And now he was in a “coma.”
I set up vigil at the ER and was advised he was awake now, but they would not let me see him yet. I let my wife know he was awake, and this was a good sign, but I hadn’t been able to see him yet.
I asked again if I could see him, and they said no but told me to wait as someone would talk to me. Out came a nurse with a clear attitude of some type—but not positive—and she said I could not and would not see him as he was going to jail because he “assaulted a nurse when he woke up.” I would learn that this was an “attempt,” as he never hurt anyone. My son has no memory of any time in the ER. He was not sober; there had not been enough time yet to get sober, and he had been beaten up viciously. In his confusion, after just being rolled and beaten by his so-called friend or friends, he struck out in his confusion, not knowing where he was or who these people were. So, I never got to see him, and I was teaching at the time—notorious for low pay—so I could not afford his bail. When he did regain some memory, he said they threw him, angrily—I don’t know, maybe a cop was dating an ER nurse, as is all too common in this business and was paying him back, who knows—but they threw him in jail, naked. He said his head hurt so bad, and he could not see straight for the five days he was there.
But this is not the end of the story.
Friends, colleagues, brothers, sisters, and any professional who will listen, I want to say and put it on repeat: Don’t be the social police! You are not tasked with cleaning up the world. You can barely control your own tempers and attitudes. Unfortunately for my boy, who did a dumb, stupid thing with his buddies (I am sure the doctors in the ER that day and the nurses had never made any mistakes), some ER decided they were going to punish a drunk 19-year-old by throwing him in jail.
Did he strike out at someone? Sure. Did I mention he was a drunk 19-year-old? Confused, just battered, unconscious for hours. Yet someone felt they needed to make an example of him, though I feel it was more of an immature act of revenge throwing him in jail.
Did they not possess enough skill, acumen, and plain common sense to understand what was going on? Why did the doctor(s) not pour some sense into the others? Did the trauma docs not know? That is scary, and as a compassionate man, I would never in a million years treat that doctor’s son like he did mine. He was not OK then, and he is not OK now. Not long after that, as I was driving through rural Utah like a crazed madman trying to get him to the ER one day, he suddenly had a grand mal seizure at the house where we lived, and in my car, he continued having violent grand mal seizures. He broke his seatbelts, he kicked the door open and jammed the shifter—not in anger, as he was not awake, but because he was seizing (maybe I should have called the cops and had him jailed?). I had to pull over and call an ambulance to our spot on the rural highway outside Moab, Utah.
And he doesn’t have seizures. He never even had febrile seizures. But he does now.
The neurologist said he had an injury on MRI from that day in Flagstaff when he reviewed it, and they just missed it. But they didn’t care, I suspect. They were going to clean up the world from bad kids like my son. I bet they still don’t care even if I told them the story again. He was hurt, and hurt badly, but they were going to set an example of him that day. I come to tears writing this because I couldn’t be there for him at that time.
Let me say the ER social police experiment didn’t work. He drank again. They did hurt him that day in the ER because they felt some sense of moral superiority and ignored him and mistreated him.
But now that he is an older, married man, he has things together, and we control his seizures.
I want to say this here and now: If you come to my ER ever, and I am working, I promise I have the skills to understand that a drunk and beat-up teenager just might be confused when they wake up from a coma (that’s what they called it). Even if he’s just drunk, I will understand and not seek revenge on him. I will stop my nurses from doing the same and explain how the brain will work.
I will not be the social police. I will love and care for your child like he was my own.
Unlike what they did for me and my child.
Dale Bingham is a physician assistant.
